Should we still be worrying about swine flu? (From The Oxford Times)

Should we still be worrying about swine flu?

4:39pm Thursday 9th July 2009 in IMAGO / Intuition

Everyone is equal in the eyes of swine flu. Whether you are a Scottish football fan or a student at Eton, the virus does not discriminate. Confirmed cases of the bug have steadily crept up in the UK, with 278 at the last count, but despite mass fear about its lethal effects, many of those who have suffered and survived claim it is no worse than catching a cold.

In Mexico, where the virus originated in pigs, the death toll has been recalculated from 159 cases to just 56.

So have we overreacted to the threat of swine flu? Or is a more dangerous strain developing, ready to hit us this winter?

According to the World Health Organisation (WHO), swine flu is currently rated as a level five threat. A "flu pandemic" is declared at level six.

This might sound bad, but the Professor of Virology at the University of Reading, Ian Jones, says it is not an indication of the flu's severity.

"There is still confusion in the public mind about the word pandemic. It doesn't mean severe infection, it simply means a very widespread infection, freely transmitting on a global scale."

Swine flu outbreaks have already forced several schools to close, including Eton College, and there are fears it could spread when children go back after the summer holiday.

Virology expert Professor John Oxford warned this week that the return to school, work and university in September could give the virus an ‘opportunity’ to become a pandemic, before a vaccine becomes available from October.

But Professor Jones believes it is more likely to spread in November, the start of our normal flu season. "There is no doubt that we can't eradicate the virus and so the spread will continue and probably will accelerate as we go into the traditional flu season.

"But I don't think there's any evidence that it will be any more severe in its second wave.

"Professor Oxford's point about children going back to school, the congregation of people, is correct, but the normal flu season is also thought to be related to the fact that people tend to crowd together in wetter, colder times of the year. They are indoors rather than outdoors, and that accelerates transmission."

How quickly swine flu will spread this winter will depend on how many people have already caught it and built up an immunity.

"Once a person is infected and has cleared the infection, they are immune, the virus can't go there. So once 'herd immunity', as it is called, in the population, builds up, then the virus will be less and less of a problem," says Professor Jones.

The current outbreak is a new strain of influenza A virus subtype H1N1, a relative of pig flu that has already existed in America for the past ten years, he explained.

Unlike the lethal H5N1 strain of bird flu, which reared its ugly head here in 2005, swine flu doesn't have to adapt itself to infect humans, meaning we might not see a stronger, mutated version appear later this year.

"In past epidemics, the virus has been adapting to human transmission because it was effectively a bird virus. But in this case, it is definitely a pig virus, a mammalian virus.

"Having said that, were it to come back in a slightly more dangerous form, then there's no doubt if you have been infected with the mild form, you would be resistant. You would almost certainly be protected come the winter. That is not to say we should all go out and try to catch swine flu.”

The Health Protection Agency is collecting data from 3,300 GP surgeries around the country, in an effort to learn about this strain of swine flu. They are advising people to take precautions against catching the disease and/or spreading it.

In the 1950s, before the days of mass immunisation, parents used to hold ‘measles parties’ to infect their children with the disease, so they would then build up a natural immunity.

Chickenpox parties also became popular.

While ProfessorJones acknowledges the benefits of building up antibodies to combat future strains of swine flu, he agrees that pox parties are definitely not to be advised.

"I don't think we should go back to the days of chickenpox parties. The virus will spread in the community anyway. I don't think there's a case for purposeful mixing and trying to persuade people to go and catch the flu. Not least because some of the people you'll be suggesting go down the road and shake hands with someone who's got it might actually have an underlying health problem. In that case, any infection is actually much more significant for them, not just this one. I wouldn't be encouraging it at this time."

Children appear to be more at risk of catching swine flu, because their immune systems are more ‘naive’, as well as the frail and elderly, who are more susceptible to respiratory conditions, said Professor Jones.

If you do catch swine flu, expect to have symptoms similar to a mild respiratory disease, such as a sore throat, aching joints, shivering and feeling cold.

"In people who have had it and have recovered, the symptoms are no different from what you would consider a common cold, so you're feeling down and out for a couple of days and then you appear to get better over the course of seven to ten days. If you suspect you have the symptoms, then seek treatment from your GP, who might prescribe you with Tamiflu,” Professor Jones said.

While a vaccine to prevent swine flu is still being developed, those who catch it are being treated with the antiviral Tamiflu. It has mild side-effects, which include nausea and vomiting, but it's generally "well-tolerated", so don't be afraid of the treatment.

"If it is prescribed within two days of infection, it effectively stops the virus spreading as widely as it would otherwise do, both in the individual and to contact members," said Professor Jones.

While we are right to be vigilant about this new strain of flu and follow good hygiene guidelines, we shouldn't be overly concerned.

"One of the dangers if you raise concerns too highly is that everyone checks themselves into accident and emergency and everything gets clogged up when actually they don't need to be there," said Professor Jones.

“If you do get the infection and the predominant outcome is not serious, at least you will be less worried about it."